Click the following headlines to get usage guidelines for typical evacuation scenarios.

HOSPITAL MANAGEMENT LEVEL

Hospital management declares a state of emergency (or Major Incident)

That message is put through the public address system in accordance with recognised local procedures.

The Chief Executive would authorise a patient evacuation, either for specific wards/departments, a hospital block, or for the whole hospital.

This message would be transmitted by agreed local procedures so all hospital staff understand that this process needs to be implemented.

The location of the Discharge Area will also be transmitted to staff, and all patients should be moved to this previously agreed area, or another area, as soon as it has been decided by management, depending on the incident location and type which gave rise to the evacuation need. I.e. A major fire might make the previously agreed Discharge Area untenable and another location might need to be decided on at short notice.

WARD OR DEPARTMENT LEVEL

Ward/Department staff should break out the evacuation equipment and prepare to move patients out of the ward/department to the notified area.

The CPES box should be opened. Inside are 2 boxes of 10 Evacuation Cruciform Cards, a Ward/Department Book and 2 pens.

Each patient should be identified by placing an Evacuation Cruciform Card round their neck, using the elastic pulled out of the bottom of the plastic sleeve, looped round the patient’s neck or other suitable place.

A qualified person in the ward/department should assign the dependency level of the patient and the mobility. Guidance on the dependency levels is inside the card. These are general dependency levels only and should allow the qualified person to form a view.

Decisions on mobility of the patient should be pragmatic and may not be ideal. If, for example, the patient is immobile in bed, it may be essential to move the patient in the bed, but ward/department staff must recognise that these patients are very difficult to transport. Can they go on an ambulance trolley?

The evacuation wrist band on the number strip attached to the card must be put round the patient’s wrist. (This band is to identify the patient for evacuation only and does not replace any hospital wrist band already on the patient – it links the patient to their originating hospital, evacuation card, possessions, notes/medication etc and enables the hospital to track that patient wherever they may go and to their final destination) It also allows the police to trace patients if they set up a Casualty Bureau.

A ward clerk or other person assigned by the Ward/Departmental Manager should take the Ward/Department book from the CPES box and document each patient in the ward/department, by placing one numbered label in the patient 1.space and writing the patient’s name underneath. Relevant gender and adult/child should be crossed by an X, and other identifiers should be X’ed across the two pages.

Continue with patient 2 and all other patients similarly.

Each patient is moved to the Discharge Area as soon as practicable.

The Ward/Department manager fills in the summary information in the back of the Ward Book, signs off all the patients moved from that ward or department and leaves the overlay sheet in the ward/department (if appropriate or tenable) and takes or sends the Ward/Department book to the designated Control Centre of the hospital.

DISCHARGE AREA LEVEL

All patients arriving at the Discharge Area should be documented into the Discharge Area book, replicating the information which should have been entered at the Ward/Department level. This ensures that patients are recorded as leaving the evacuating hospital, using the unique number/bar code as the identifier.

If patients arrive at the Discharge Area without an Evacuation Cruciform card attached, due to absolutely necessary speed of evacuation from the Ward/Department, the manager in charge of the Discharge Area must ensure that the patients are documented with an Evacuation Cruciform card before they leave the hospital by transport. (Some CPES Ward/Department boxes must be available to staff at the Discharge Area for this purpose)

If the police are involved with the evacuation and set up a Casualty Bureau, which is most likely in practice, they should be offered the overlay sheets from the Evacuation Cruciform cards, which should contain some administrative information about the patient but no medical information. The overlay sheet does have the unique number/bar code already attached from the manufacturing process. This will considerably assist the police in tracking patients so they can be traced later.

ALL STAFF SHOULD BE AWARE, OR MADE AWARE, THAT THE EVACUATION CRUCIFORM CARD MUST NOT BE REMOVED FROM THE PATIENT UNTIL THEY HAVE ARRIVED AT THEIR FINAL DESTINATION.

AMBULANCE SERVICE OR OTHER TRANSPORT STAFF

Staff transporting patients being evacuated should take one numbered label for their records, so the patient can be traced through transport.

RECEIVING LOCATION/FINAL DESTINATION

Staff receiving patients who have been evacuated from a hospital should note their name and number into their Receiving Location book before they are moved to a ward or other location.

If any patient has to be moved further, for any reason, such as lack of space, the patient’s name and number should be logged into the book, using a label from the strip, but nothing belonging to or associated with the patient should be removed from the patient but conveyed with the patient to the next location. This naturally also applies to the Evacuation Cruciform card and Evacuation numbered wrist band.

Important information about Barcodes

The barcode strips supplied should be applied (as a minimum) to the patient’s wrist, Evacuation Cruciform card and Ward / Department logbook. They uniquely identify the patient in space and time according to the GS1 standard, and can be read using dedicated barcode readers or an app available for most smartphones.

Hospital staff that may be likely to discharge or receive evacuation patients should ensure that they have access to a dedicated barcode reader or download a barcode reader app to their smartphone. These measures should be carried out and tested prior to any need.

nb. though the above smartphone barcode readers have been tested, we do not endorse them for use in the field. We strongly recommend that organisations carry out their own trials to ensure suitability.